Signs and symptoms questionnaire

See Introduction of B/SS Medical Advisory Commitee

* All the questions must be answered

Have you run or done some other exercise of similar intensity for at least 30 minutes per session and at least 3 days a week for at least the past 3 months?

Have you previously taken part in any race without any problems?

Have you ever been diagnosed with heart disease, circulatory or kidney problems, or diabetes mellitus?

Have you ever had pain, discomfort or tightness in the chest, neck, jaw or arms while exercising?

Have you ever experienced unexplained dizziness or syncope (fainting)?

Have you ever had unexplained palpitations or a feeling of an accelerated heartbeat?

Do you have an unusual and disproportionate feeling of tiredness or shortness of breath during exercise?

Have you ever had a heart murmur detected that has not been studied?

Do you have difficulty breathing while lying down that improves when sitting up?

Have you had unexplained swelling in both ankles (oedema)?

Have you lost more than 10% of your bodyweight without trying in the last 6 months?

Has anyone in your immediate family (parents, children or siblings) died suddenly or unexpectedly or suffered a cardiac arrest due to a heart problem before the age of 50?

Does anyone in your immediate family (parents, children or siblings) have a disability or invalidity or have they been diagnosed with heart disease before the age of 50?

PIE DE PÁGINA

PÃo Baroja, 47 - 20008 Donostia / San SebastiÃ¡n (Gipuzkoa)
T. 943 314 859 - Contact